Does Obamacare’s Independent Payment Advisory Board (IPAB) Ration Medicare or Create “Death Panels”? – DEBATED

“Perhaps one of the most troubling parts of Obamacare is the Independent Payment Advisory Board (IPAB). The IPAB will consist of fifteen unelected bureaucrats who are granted substantial powers to reduce Medicare spending. IPAB’s proposals could, for example, cut reimbursement for specific services that it determines not to be of high value. As a physician, I can tell you first-hand how troubling this mindset can be – every case is unique and must be treated that way…

Supporters of the board like to claim that IPAB is prevented from rationing care, and as far as the language of the law reads, that’s true. But dig a little deeper and you find out what’s prevented depends on how you define the word ‘rationing.’ The IPAB is not allowed to say that a person should be denied a particular treatment or type of care, but the IPAB is allowed to cut payments to the physicians that perform these treatments low enough that the effect is no physician is willing to provide the treatment. In my view, the board is rationing care if the effect of their decisions is reduced access to needed care.

Because I am so concerned about the power of this unelected board, I have been an outspoken opponent of the IPAB and have introduced legislation, H.R. 351, to repeal it.”

“Clearly, the foremost achievement of President Obama’s first term is the Affordable Care Act, and when fully implemented the law will move America closer to universal health coverage—something many progressives have sought for years…

That said, the law still has its flaws, and American lawmakers and citizens have both an opportunity and responsibility to fix them.

One major problem is the so-called Independent Payment Advisory Board. The IPAB is essentially a health-care rationing body. By setting doctor reimbursement rates for Medicare and determining which procedures and drugs will be covered and at what price, the IPAB will be able to stop certain treatments its members do not favor by simply setting rates to levels where no doctor or hospital will perform them.”

“Though I was called a liar [in 2009] for calling it like it is, many of these accusers finally saw that Obamacare did in fact create a panel of faceless bureaucrats who have the power to make life and death decisions about health care funding. It’s called the Independent Payment Advisory Board (IPAB), and its purpose all along has been to ‘keep costs down’ by actually denying care via price controls and typically inefficient bureaucracy. This subjective rationing of care is what I was writing about in that first post [on Aug. 7, 2009]:

‘The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care. Such a system is downright evil.'”

“[Under Obamacare] the department of Health and Human Services (HHS) will be empowered to impose so-called ‘quality and efficiency’ measures on health care providers, based on recommendations by the Independent Payment Advisory Board, which is directed to force private health care spending below the rate of medical inflation. In many cases treatment that a doctor and patient deem needed or advisable to save that patient’s life or preserve or improve the patient’s health but which runs afoul of the imposed standards will be denied, even if the patient wants to pay for it.

The law empowers HHS to prevent older Americans from making up with their own funds for the $555 billion the law cuts from Medicare by refusing to permit senior citizens the choice of private-fee-for-service plans whose premiums are sufficient to provide unrationed care but which HHS, in its unlimited discretion, disallows. The Obama health care law could thus lead to elimination of the only way that seniors will have to escape rationing — by limiting their right to spend their own money to save their own lives.”

“IPAB’s unique ‘fast track’ authority divests Congress of discretion regarding the amount of money to be cut from Medicare once IPAB has submitted its ‘advice.’ Get a load of these legislative handcuffs:

By January 15, 2014, IPAB must submit a proposal to Congress and the president for reaching Medicare savings targets in the coming year.

The majority leaders in the House and Senate must introduce bills incorporating the board’s proposal the day they receive it.

Congress cannot ‘consider any bill, resolution, amendment, or conference report… that would repeal or otherwise change the recommendations of the board’ if such changes fail to meet the board’s budgetary target.

By April 1, all legislative committees must complete their evaluation. Any committee that fails to meet the deadline is barred from further consideration of the bill.

If Congress does not pass the proposal or a substitute plan meeting the IPAB’s financial target before August 15, or if the president vetoes the proposal passed by Congress, the original Independent Payment Advisory Board recommendations automatically take effect.

Not only that, but Congress cannot consider any bill or amendment that would repeal or change this fast-track congressional consideration process without a three-fifths vote in the Senate. And to put the icing on the autocratic cake, implementation of the board’s policy is exempted from administrative or judicial review.”